Show up at Methodist West Houston Hospital with chest pain, and a government database suggests you will find out if you are having a heart attack within 60 seconds.

That's seven minutes faster than the national standard.

The Harris County Hospital District meets the national benchmark of eight minutes at its two hospitals: Lyndon B. JohnsonGeneral Hospital and Ben Taub General Hospital, which has one of the city's two Level 1 trauma centers, which provide the highest level of care.

At the second Level 1 trauma center, Memorial Hermann-The Texas Medical Center, patients with heart attack symptoms wait an average of 29 minutes - more than three times longer than the national standard - for an electrocardiogram.

But the database also notes that it includes too few cases to reliably gauge the hospital's performance in that category.

The government figures,produced by the Centers for Medicare and Medicaid Services, show that the county's public hospital district and several suburban hospitals scored well on key measures, including the pivotal rating of how quickly potential heart attack patients are diagnosed. And some of the best-known hospitals in the Texas Medical Center scored below the national average in a number of categories.

"There is this stigma of what county (hospital) care used to be," said Dr. Nasser Lakkis, chief of cardiology at Ben Taub. "We refute that."

Only three Medical Center-area institutions - the hospital district, Memorial Hermann and St. Luke's Episcopal Hospital - met the national benchmark for getting heart attack patients into the catherization lab within 90 minutes to open blocked blood vessels. (Park Plaza Hospital did not provide the information.)

Ten of the 14 suburban hospitals that were rated met the standard.

Flunking on infections

And every Medical Center-area hospital scored worse than the national standard in the category of hospital-acquired infections caused by a catheter in a large vein. (The DeBakey VA Medical Center did not provide the information.)

Nine of the 14 suburban hospitals flunked the national standard in that category.

St. Luke's Episcopal Hospital,nationally ranked in 10 specialties by U.S. News and World Report, scored below the national average in a number of categories, including death rates among patients with serious, treatable conditions and in the rate of hospital-acquired conditions, ranging from objects accidentally left in a patient's body after surgery to catheter-caused infections.

U.S. News says its rankings are based on surveys of both specialists and data, including death rates and patient safety statistics.

Debra Simmons, senior vice president of quality for the St. Luke's Episcopal Health System, said the hospital does a "deep-dive investigation" for every reported hospital-acquired infection or other potential problem, and predicted it will show improvement when the next round of data is posted.

Simmons noted that different quality rankings collect, analyze and report data differently, but she and executives from other hospitals recommend that anyone with concerns ask questions.

"People need to have that conversation with their provider," Simmons said. "If you're in the hospital, you can ask to talk to any of us."

Helping people choose

Increasingly, the government is trying to gauge the quality of care provided in the nation's hospitals. Some hospitals will lose a portion of their Medicare funding this fall based on several of the measures, including patient satisfaction scores and how many patients return to the hospital after being treated for certain conditions.

Dr. Patrick Conway, chief medical officer for the Centers for Medicare and Medicaid Services, said the ratings are meant to help patients and their families choose the best hospital.

Conway said the initial measures chosen for the project, which began in 2005, focused on practices that research has shown to work, including giving heart attack patients an aspirin and getting them into the catheterization lab within 90 minutes to open blocked blood vessels before heart muscle is permanently damaged.

Conway said that as more hospitals score well on the current measures, the government will replace them with new measures, to ensure that hospitals are rated across a broad range of categories.

Andrulis encourages patients and their families to see how local hospitals compare on measures dealing with their health care concerns, and to ask questions if one hospital fares more poorly than others.

Children's hospitals aren't included in the database, nor are psychiatric or cancer hospitals.

Conway said a program to rate cancer centers is under way.

A few hospitals are lumped with others in the same system, so their individual ratings can't be broken out. Ratings for four Memorial Hermann hospitals - Northwest, Southeast, Southwest and The Woodlands - are combined because they operate under a common Medicare number, for example.

Memorial Hermann and other hospitals take the numbers seriously, Shabot said.

"For quality measures where you want high numbers, we have one goal: 100 percent," he said.

And for the statistics reflecting bad results - sponges left inside a patient's body during surgery, for example - hospitals want the report to say "zero."

But few hospitals were at zero across the board in the latest data, which covers the period from Oct. 1, 2010, to Sept. 30, 2011.

Memorial Hermann-The Texas Medical Center reported 0.131 "objects accidentally left in body after surgery" for every 1,000 patient discharges, although Shabot said the hospital has since gone 12 months without an incident. (The national average is 0.028 incidents for every 1,000 patient discharges.)

Memorial Hermann, St. Luke's and The Methodist Hospital were among the local hospitals that scored below the national average in the category of causing a collapsed lung due to medical treatment.

Listening to patients

But Maureen Disbot, vice president for quality operations at Methodist, said that's not necessarily as bad as it sounds; it could mean only a slight decrease in lung volume, and she said the definition has since been changed.

Patients' voices are about to count more than ever.

Under the Affordable Care Act, the Centers for Medicare and Medicaid Services will withhold 1 percent of Medicare reimbursements starting in October and redistribute it based on hospital performance according to patient surveys.

That goes up to 2 percent in 2016.And patients can be a tough audience. While most say they were given instructions upon leaving the hospital, far fewer say they "always" received help as soon as they wanted it, or that the area around their rooms was "always" quiet at night.

"We have to remind (employees) it's not 2 o'clock in the afternoon," Disbot said. "All the equipment that passes by needs to be muffled."

Many hospitals also will lose Medicare funding over re­admissions - patients returning to the hospital within a month after being treated for certain conditions.

Even hospitals whose re­admission rates are at the national average will lose money.

"You won't be able to reduce it to zero," said the hospital district's chief medical officer, Dr. Fred Sutton. "A lot of our patients don't go home to a home. We have patients that are homeless."

Follow-up care

Having a staff member follow up after patients leave the hospital can reduce the risk, Sutton said. That requires additional staff time, but the district is trying it with patients discharged from the emergency room.